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Miscellaneous - 243 BEAR HILL ROAD 4/30/2018
AML Safety Insurance PO Box 55098 Boston, MA 02205 Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Board of Health or Inspector of Buildings Board of Selectman City Hall City Hall NORTH ANDOVER, MA 01845 NORTH ANDOVER, MA 01845 RE: Insured: MARK A SUTERA and LAUREEN A SUTERA Property Address: 243 BEAR HILL ROAD, NORTH ANDOVER, MA Policy Number: HMA 0106087 Claim Number: BOS00069827 Date of Loss: 4/10/2016 Company: Safety Indemnity Insurance Company Claim has been made involving loss, damage or destruction of the above -captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass. Gen. Laws, Chapter 139, Section 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim number. Anne Dunphy Claim Examiner Safety Insurance Company Homeowners Claims Unit P. O. Box 55098 Boston, MA 02205-5098 Phone: (617) 951-0600 EXT 3061 Fax: (617) 531-6644 Email: annedunphy@safetyinsurance.com 5/31/2016 49 Date .......... 1.-.//...:/... / TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ............ v�..�?............. �u....,1..................................... has permission to perform .... el— .,✓....r...'`.... �... ............................... wiring in the building of........�..P.. r!................................................................. at ....... rte................/� ............... ,North Andover, Mass: A Fee .. .. ................ Lic. Nolxh" ;3��...............�, � .... .......:.. ,r .......... _ ,LLECTRICAL INSPECTOR Check #� q �mrnonw o���a�ru�iuse(f� Official Use Only eUeparfirzent o��ue �ewice6 Permit No. Occupancy and Fee Checked BOAR© OF FIRE PREVENTION REGULATIONSpt". l/o7] (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date. City or Town -of. M,4W 4wgve!r2 To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 24(3 �,44L A4 Owner or Tenant Adex Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 44 No ❑ (Check Appropriate/)Box) Purpose of Building Utility Authorization No. _ Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: �7GD� 4314��j4114 Cmmnlotinn nrd.. f 11..,.:., . r .z h », , i ,.. a L.. 4 sur._,,.. No. of Recessed Luminaires /-S— No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Ll Swimming PoolAbove ❑ In- ❑ d. rnd. o. o mergency Lighting AlgLa Units No. of Receptacle Outlets /0 No. of OR Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and 1nitiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers / Heat Pump Totai: Number Tons KW No. o Self -Contained Detection/AlertingDevices No. of Dishwashers / Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW securitySystems:* No. of Devices or Equivalent No. of Water. KW Heaters No. of No. of si Ballasts Data Wiring: Na of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Estimated Value of Electrical Work: ftuacn aaamonat aerau 1J desired, or as required ty the Inspector of YPires. (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INTSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under thepains andpenalties ofperjury, that the information on this application is true and complete: FIRM NAME: DAVID E L 1~ c� T R I CA I_ CO3`J 1_R r -Marla/ J_ LC LIC. NO.: Licensee:AV t t7 1- ACUCz h Signature-- LIC. NO.: j il Ct b (Ifapplicable, enter "exempt" in the license mtntber line) j Bus. Tel. No.:y �� `F� 1= b��� *Per M.Gs._ c. 147, s. 57-51, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one ❑owner ❑ owner's a ent. OwnerlAgent _ Signature Telephone No. PERMIT FEE. $ 5 3 iCtiti �� %-Z ie OF The Commonwealth of Massachusetts Department of IndustrialAccidents N Office of Investigations ' d 1 Congress Street, Suite 100 w Boston, MA 02114-2017 swww mass.gov/dia Workers' Compensation Insurance Affidavit: General Businesses Applicant Information Please Print Legibly Business/Organization Name: DAVID ELECTRICAL CONTRACTING LLC Address: 87 BELMONT ST City/State/Zip: NORTH ANDOVER, MA 01845 Phone #: 978-682-6262 Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 8 employees (full and/ or part-time).* 2. ❑ 1 am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required] 3. ❑ We are a corporation and its officers have exercised their right of exemption per c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required]** 4. ❑ We are a non-profit organization, staffed by volunteers, with no employees. [No workers' comp. insurance req.] Business Type (required): 5. ❑ Retail 6. ❑ Restaurant/Bar/Eating Establishment 7. ❑ Office and/or Sales (incl. real estate, auto, etc.) 8. ❑ Non-profit 9. ❑ Entertainment 10. ❑ Manufacturing 11. ealth Care 12 her ELECTRICAL CONTACTING *Any applicant that checks box # 1 must also fill out the section below showing their workers' compensation policy information. **If the corporate officers have exempted themselves, but the corporation has other employees, a workers' compensation policy is required and such an organization should check box # 1. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy information. Insurance Company Name: FEDERATED MUTUAL INSURANCE CO Insurer's Address: PO 60X328 City/State/Zip: OWATONNA, MN. 55060 Policy # or Self -ins. Lic. # 9353694 Expiration Date: MARCH 1, 2015 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA forjn§i ranceAoverage verification. I do hereby certify, unde the airi penalties of perjury that the information provide dbov is true and correct. Signature: / Date: U Phone #: V -(/I VI Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Licensing Board 5. Selectmen's Office 6. Other Contact Person: Phone #: www.mass.gov/dia �ocation Ala) ' No. Date GI-- I 2� 114 TOWN OF NORTH ANDOVER Certificate of Occupancy $ '"''��yt Building/Frame Permit Fee $ / N Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #*"' 721 -� j Building Inspector TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: GJ` -r S � Date Received Date Issued: t'I IMPORTANT: Applicant must complete all items on this page LOCATION Priint. PROPERTY OWNER _ 4 Print 100 Year Old Structure yes MAP NO: 0(.S PARCEL:. td . ZONING DISTRICT: Historic District yes. Machine Shop Village . yes .TYPE OF IMPROVEMENT, PROPOSED USE Residential Non- Residential ❑ New Building P-@ne family ❑ Addition ❑ Two or more family ❑ Industrial *Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑ Floodplain 0 Wetlands ❑ Watershed District OVater/Sewer _ DESCRIPTION OF WORK TO tat F'tKruKmtU: J&O!,�,e\ \���c.ti,e 2 "-oie- WA1\ �t.,� C•��1-roo 1� Identification Please Type or Print Clearly) OWNER: Name: ni\,Ac1c, :5v+e-'CA Phone: 6 t'1 b -7a \30 Address: � `t CONTRACTOR Name: _ 5 T� S 'A _ _ _ Phone: 97'.% G. -1" ,),0 ', 3 Address: Supervisor's Construction License: 5 O 5 y l 1 Exp. Date: Home Improvement License: O��: _ Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. —7 Total Project Cost: $ C St ® O 0 FEE: $ / 6L/ Check No.: �� Receipt No.: 2-1 (pZ NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund -� gSignat � u of Agent/Owner Y� Slg nature of contractor'. Plans Submitted 'LJ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Building Department °The fol :owing is;A-Iist of -the :required.forms to be filled out-for.:the appropriate permit to be obtained. Roofir,g, Siding, Interior Rehabilitation Permits U.Btailding Permit Application o Workers Comp Affidavit o Photo Copy Of H.I.C. And/OrC`.S. Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster. permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application o Certified Surveyed Plot Plan a Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Li Mass check Energy Compliance Report (If Applicable) o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) o Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract a Mass check Energy Compliance Report L3 Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apu•?al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm.+.ted with the building application Doe: Doc.Building Permit Revised 2012 - - Plans -Submitted ❑ PlansWaived ❑ .7..Certified Plot Plan ❑ Stamped Plans ❑ :TYPE_OYSEWERAGE DISEOSAL" Zoning Board of Appeals: Variance, Petition No: Public Sewer ❑ Tanning/Massage/BodyArt ❑ .....Swimming Pools ❑ Well ❑ ..Tobacco Sales El. - Food Packaging/Sales ❑ Private(septic tank, etc_:11El= : Permanent Dunpster on Site =THE -FOLLOWING SECTIONS FOR OFFICE USE ONLY _ INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED 'PLANNING & DEVELOPMENT ❑ DATE:APPROVED COMMENTS CONSERVATION Reviewed on Signature COMMENTS N(. HEALTH Reviewed on Signature MMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Nater & Sewer Connection/signature .Date Driveway Permit DPW 'Tod,Ya! Engineer: Signature: - FIRE_DE PARTME—'NT - Temp Dumpster on site Located 384 Osgood Street .yes. Located -at 124 Mair, Street - no Fire Departmerit'signatu"r`e ,. COMMENTS r . -Dimension Number of Stories: Total land area, sq.. ft.: Total square feet of floor area, based on Exterior dimensions. 1 ELECTRICAL: ,movement of. Meter l-acation"must-or service drop requires approval of i Electrical Inspector Yes No ®ANGER Z®NE LITERATURE: Yes No MGL .Chapter 166.Section 21A. F and G min. 100= 1000 $ $ fine Doc.Building Permit Revised 2010 Enter construction cost for fee cal - North Andover Fee Cakulation Construction Cost $ 65,000.00 m $ - $ 780.00 Plumbing Fee $ 97.50 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 97.50 Total fees collected $ 1,075.00 243 Bear Hill Road 861-14 on 5/28/2014 Kitchen Remodel ACCME� CERTIFICATE OF LIABILITY INSURANCEDATE (MMMDIYYYY) 1 05/29/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorseme s . PRODUCER NAM& R. W. Testa Insurance Agency, Inc. PA",c°NNa, (978) 685-1150 (AIC, Na)- (9701 601-9002 855 Turnpike Street ADDRESS: testains@aol.com PRS c -CUSTOMER ID P - TESTA, JAMES 6 MARY North Andover MA 01845- INSURERS AFFORDING COVERAGE NAIL# INSURED INSURER A :COMMOrCe Insurance Company TESTA BUILDING AND REMODELING INSURER B 5 APPLETON ST INSURER C INSURER D INSURER E N ANDOVER MA 01845-3119 F.U.R F , COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. OR 'TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIODIYYYY) (MWDONM) LIMITS NORTH ANDOVER, MA 01845 GENERAL LIABILITY 16388 6/01/2013 6/01/2014 EACH OCCURRENCE $ 1,000,000 I $ 100,000 X COMMERCIAL GENERAL LIABILITY 06/01/2014 6/01/2015 CLAIMS -MADE a OCCUR / / / / MED EXP (Any ono Letson $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENI AGGREGATE LIMIT APPLIES PER: / / / / PRODUCTS -COMPIOP AGG S 1,000,000 PP $ 10, 000 POLICY f PR FCf 71 LOC / / / / AUTOMOBILE LIABIUTY / / / / COMBINED SINGLE LIMIT $ (Es accident) BODILY INJURY (Per peraan) $ ANY AUTO BODILY INJURY (Per occident) $ ALL OWNED AUTOS SCHEDULED AUTOS / / / / PROPERTY DAMAGE HIRED AUTOS / / / / $ (Per Bccldent) $ NON -OWNED AUTOS / / / / UMBRELLA UAD OCCUR / / / / EACH OCCURRENCE $ AGGREGATE $ EXCESe uae CLAIMS -MADE / / / / DEDUCTIBLE / / / / RETENTION S $ WORKERS COMPLNSAMN WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOPJPARTNERIEXECUINE E.L. EACH ACCIDENT $ OFFICEIRWEMBER EXCLUDED N / A (Mandatory In NH) E.L.DISEASE - EA EMPLOYE I itea, descr1 0 under / / / / DVSCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DE5CRIP1ION Of OPERATIONS I LOCATIONS I VEHICLES (AVAch ACORD ID7, Additional Remarks Schedule, N mote space is r-qulrwl) CCRTIrICATF Idf11 nr-12 CAMCFI I ATIAN ACURD Z5 (2009109) 191=5-ZUUV AVVKU L;VKI-VKA I IUrY I rlgms reserved. INS026 (200909) The ACORD name and logo a Istered marks of ACORD 7,0/Z0 39dd 33NV7jnSNI d1S31 M d Z006T898L6 CS:ZT VT0Z/6Z/S0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. NORTH ANDOVER BUILDING INSPECTOR 1600 OSG-OOD STREET AUTHORIZED REPRESENTATIVE NORTH ANDOVER, MA 01845 ACURD Z5 (2009109) 191=5-ZUUV AVVKU L;VKI-VKA I IUrY I rlgms reserved. INS026 (200909) The ACORD name and logo a Istered marks of ACORD 7,0/Z0 39dd 33NV7jnSNI d1S31 M d Z006T898L6 CS:ZT VT0Z/6Z/S0 0 ENO m 'V'wl V/ M E r � d J LU 2 LL O m C cu t O O V- E +O+ ? Q. Q/ N Q a of Z 0 J m C 0 O O LL to O O K N C t U m C LL 0 a v1 Z i d -COD = OC �' U- 0 0. of z W W �b0 O O O U O N ca C U- U W d Q L7 MD 7 O OC C LL Z CC Q W � LL v E 7 OJ O Z v N a+ N N O E N O� .N 'Q JCL ja) Cc= - 00a - �� 0 :. �: O :, N N J= A< �• E i V CD �� A y�l �: •� O •� H y C N J i d � �: r L- m N Z ; aa) c Vp �-O H O N WWN O d > I.f. � O 'a > -cu t �Q r- x damp _ N O W Q!, L- O z H O Q. N '... C G N 2 O O O = � Co > 3 C W CLCL tr • cc $ 0 0 L CO) c = c p cc �a G O CL ai •� N F- O v) v m N N O w .+ W_ p w O LL • -N o �C �O LLJ LUQ =O 0s O wE 0-o0 V CD a� O� Nd > p J y o _0 .mac CL 0 0 > C. W O O O ^v/ W L t V .CL N C U cc m CLN lw L.: 0 CLd U) O m m 0 0 O CL Q. Q J � O Z N FRANCIS H. COLLOPY Structural Engineering Services FRANCIS H. COLLOPY, P.E. P.O. Box 1684 Registered Professional Engineer Mr Jim Testa Testa Construction 5 Appleton St North Andover, MA 01845 Dear Mr Testa: Seabrook, NH 03874 Tel: 603 760-2273 May 27, 2014 The purpose of this Report is to provide you with the applicable framing design sheet for the proposed renovation to the Sutera Residence at 243 Bear Hill Road in North Andover, MA. I have provided design sheet D 1 which shows the required framing beams required for the proper support for the renovations planned as described to me recently during a site visit at this residence. During that site visit, I inspected the existing framing at all floor levels in the vicinity of the proposed changes that would affect the floor loading on the beams designed to support these changes, as shown on sheet D1. These changes are primarily in the left rear of the residence. The new beams are located at the second floor framing level, and are over new openings at the first floor level, that are desired by the Owner. I have checked the framing at the first floor level as observed from the basement area, including the joists, the main carrying beam and the existing support lally columns. At that time I requested that you drill some exploratory holes in the basement concrete slab, and your drilling in a number of places indicated that there was an existing 1.2 inch deep, 30 inch wide strip footing. This footing is more than capable of supporting the changes indicated including the addition of a new column and bearing plate at the basement level which will be adjacent to an existing lally column. You requested that I prepare this Report with the necessary design drawings that will be provided to the North Andover Building Inspector's Office. If you have any questions in this regard, please do not hesitate to call this Office, and we can discuss it further. Enclosure: Design Sheet Dl Sincerely, Francis H. Collopy, P.E. Structural Engineer FRANCIS H. COLLOPY PE JOB Structural Engineer SHEET NO. DI / [ OF P.O. Box 1684 CALCULATED BY �/ / DATE Z 1 T Seabrook, NH 03874 TEL: 603 760-2273 CHECKED BY DATE A: SCALE �/ _ _.. w' 1 Building and Remodeling 5 APPLETON STREET NORTH ANDOVER, MA 01846 11/19/15 (978) 682 2023 618114 Proposal Mark and Laureen Sutera 243 Bear Hill Road North Andover, MA 01845 j2W Remodel kitchen Start date 612/14 Finish date 7/31/14 HIC Lic. 120296 Expires CSL Lic. CS 54718 Expires Revised April 10, 2014 Home Phone: (978) 681-4553 Obtain building permit Obtain structural plans Complete removal of all demolition and construction materials generated By Testa Building and Remodeling and its subcontractors. DEMOLITION: Remove all cabinets and counter tops. Total gut all the walls and the ceiling in the kitchen. Remove the Kitchen floor down to the sub floor. Remove the boxed out window over the kitchen sink. Remove walls between kitchen and Dining room and between kitchen and living room CONSTRUCTION: Install two beams and recess them into the ceiling. Remove bay window in kitchen and block up. Patch the cedar clap boards that get disturbed. Install a new window over the kitchen sink, Install a new triple double hung window in the front of the living room. Install a new fire rated door between the garage and living room. PLUMBING: Remove a strip of heat in the kitchen and add a kick space heater. Relocate the dish washer. Plumb the new sink and appliances. Note: There is no allowances for plumbing fixtures for the kitchen. ELECTRICAL: Remove all old wiring in the kitchen area. Rewire kitchen to code. Supply and install 18 recessed lights. Supply and install under cabinet lights. Wire all new appliances. Note: There is no allowances for light fixture other than the one specified. INSULATION: Install R 15 insulation with a vapor barrier on all the exterior walls. PLASTER: Hang '/12" blue board on the ceilings and the walls. Skim coat plaster will be applied to all the walls and ceiling in the kitchen. Skim over the dining room and living room ceiling. as provided In Massachusetts General Laws, chapter 142A. Homeowner's Signature Contractor's Signature NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution initiated by the contractor. The homeowner may initiate alternative dispute resolution even where this section is not separately signed by the parties. Homeowner's Rights A homeowner's rights under the Home Improvement Contractor Law (MGL chapter 142A) and other consumer protection laws (i.e. MGL chapter 93A) may not be waived in any way, even by agreement. However, homeowners may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law. Homeowners who secure their own building permits are automatically excluded from all Guaranty Fund provisions of the Home Improvement Contractor Law. The contractor is responsible for completing the work as described, in a timely and workmanlike manner. Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship ormaterials. In addition to guarantees or warranties provided by the contractor, all goods sold in Massachusetts carry an implied warranty of merchantability and fitness for a particular purpose. An enumeration of other matters on which the homeowner and contractor lawfully agree may be added to the terms of the contract as long as they do not restrict a homeowner's basic consumer rights. If you have questions about your consumer/homeowner rights, contact the Consumer Information Hotline (listed below). Execution of Contract The contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced documents have been attached. Parties are also advised not to sign the document until all blank sections have been filled in or marked as void, deleted, or not applicable. One original signed copy of the contract with attachments is to be given to the owner and the other kept by the contractor. Any modification to the original contract must be in writing and agreed to by both parties. Contracted work may not begin until both parties have received a fully executed copy of the contract, and the three day rescission period has expired. Accelerated Payments A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the homeowner deems him/herself to be financially insecure. However, in instances where a contractor deems him/herself to be financially insecure, the contractor may require that the balance of funds not yet due be placed in a joint escrow account as a prerequisite to continuing the contracted work. Withdrawal of funds from said account would require the signatures of both parties. Additional Information If you have general questions or need additional information about the Home Improvement Contractor Law or other consumer rights, or if you wish to obtain a free copy of "A Massachusetts Consumer Guide to Home Improvement" contact: Consumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza, Room 5170, Boston, MA 02116 617-973-8787, 888-283-3757 or visit the OCABR website at http://www.mass.gov/ocabr/ If you want to verify the registration of a contractor or if you have questions or need additional information specifically about the contractor registration component of the Home Improvement Contractor Law, contact: Director of Home Improvement Contractor Registration Office of Consumer Affairs and Business Regulation 10 Park Plaza, Room 5170, Boston, MA 02116 617-973-8787, 888-283-3757 or visit the IRC website at http:/hvww.mass.gov/ocabr/ Go online to view the status of a Home improvement Contractor's Registration: llttp://db.state.ma.us/homeimprovement/licenseelist.as For assistance with informal mediation of disputes or to register formal complaints against a business, call: Consumer Complaint Section Office of the Attorney General 617-727-8400 AND/OR Better Business Bureau 508-652-4800,508-755-2548 or 413-734-3114 Version 2.1-11/22/201 NOTICE OF CANCELLATION YOU MAY CANCEL THIS TRANSACTION, WITHOUT PENALTY OR OBLIGATION, WITHIN THREE BUSINESS DAYS FROM THE ABOVE DATE. IF YOU CANCEL, ANY PROPERTY TRADED IN, ANY PAYMENTS MADE BY YOU UNDER THE CONTRACT OR SALE, AND ANY NEGOTIABLE INSTRUMENTS EXECUTED BY YOU WILL BE RETURNED WITHIN TEN BUSINESS DAYS FOLLOWING RECEIPT BY THE SELLER OF YOU CANCELLATION NOTICE, AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CANCELED. IF YOU CANCEL, YOU MUST MAKE AVAILABLE TO THE SELLER AT YOUR RESIDENCE, IN SUBSTANTIALLY AS GOOD CONDITION AS WHEN RECEIVED, ANY GOODS DELIVERED TO YOU UNDER THIS CONTRACT OR SALE; OR YOU MAY, IF YOU WISH, COMPLY WITH THE INSTRUCTIONS OF THE SELLER REGARDING THE RETURN SHIPMENT OF THE GOODS AT THE SELLER'S EXPENSE AND RISK. IF YOU DO MAKE THE GOODS AVAILABLE TO THE SELLER AND THE SELLER DOES NOT PICK THEM UP WITHIN TWENTY DAYS OF THE DATE OF CANCELLATION, YOU MAY RETAIN OR DESPISE OF THE GOODS WITHOUT ANY FURTHER OBLIGATION. IF YOU FAIL TO MAKE THE GOODS AVAILABLE ATHE SELLER, OR IF YOU AGREE TO RETURN THE GOODS TO THE SELLER AND FAIL TO DO SO, THEN YOU REMAIN LIABLE FOR PERFORMANCE OF ALL OBLIGATIONS UNDER THE CONTRACT. TO CANCEL THIS TRANSACTION, MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE OR ANY OTHER WRITTEN CARPENTRY: Install all the kitchen cabinets and molding as per the designers drawings. Install new trim in the kitchen and living room around all new windows and doors to match the existing trim in the house. Installation of all kitchen appliances. Install new solid core bi fold door in front of the laundry. FLOORING: Install new oak flooring in the kitchen. Sand and poly three coats in the living room, kitchen, dining room, foyer and the laundry/bathroom area. TILE: Install and grout tile for kitchen back splash.. Note: No allowance for file and grout. Labor and adhesive only. VENTING: Pipe the exhaust blower for the stove. Will provide all duct work needed. NOTE: There is no allowances for painting or staining interior or exterior. There is no allowances for Kitchen cabinets, granite, plumbing. fixtures, appliances, tile and light fixtures. A finance charge of V/2% per month (18% per year) will apply to all accounts over 30 days past due. In the event collection activity is required the customer shall be responsible for all costs associated with collection including reasonable attorney's fees. I propose hereby to furnish material and labor complete in accordance with above specifications, for the sum of - $37,050 f:$37,050 Thirty Seven Thousand Fifty Dollars One- third to start, one-third after rough inspection, one- third upon completion. Authorized signature I reserve the right to cancel this contract if not accepted in 30_ days DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES This form satisfies all basic requirements of the state's Home Improvement Contactor Law (MGL chapter 142A), but does not include standard language to protect homeowners- Seek legal advice if necessary. Any person planning home improvements should first obtain a copy of "A Massachusetts Consumer Guide to Home Improvement" before f, 7Li-100`1 agreeing to any work on your residence. You may obtain a free copy by calling the Office of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1-888-283-3757 or on our website. (Owners who secure their own permits will be excluded from the Guaranty Fund provisions of Date when contractor will begin contracted work. MGL chapter 142A.) Express Warranty - Is an express warranty being provided by the contractor? No Yes (all terms of the warranty must be attached to the contract) Subcontractors - The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this agreement. Contract Acceptance - Upon signing, this document becomes a binding contract under law. Unless otherwise noted within this document, the contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices carefully before signing this contract. ®®Don't be pressured into signing the contract. Take time to read and fully understand it. Ask questions if something is unclear. ® ®Make sure the contractor has a valid Home Improvement Contractor Registration. The law requires most home improvement contractors and subcontractors to be registered with the Director of Home Improvement Contractor Registration. You may inquire about contractor registration by writing to the Director at 10 Park Plaza, Room 5170, Boston, MA 02116 or by calling 617-973-8787 or 888-283-3757. ®®Does the contractor have insurance? Ask the Contractor for his insurance company information so that you can confirm coverage, or ask to see a copy of a "proof of insurance" document. ®®Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business, provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!! Two identical copies of the contract must be completed and signed. One copy should go to the homeowner. The other copy should be kept by the contractor. Homeowner's Signature Contractor's Signature Date Date Contractor Arbitration The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration action (as an alternative to court action) if they have a dispute with a contractor. The same right is not automatically afforded to a contractor, however. The contractor would have to resolve any dispute he/she has with a homeowner in court unless both parties agree to the optional clause provided below. This clause would give the contractor the same right to arbitration as is afforded to the homeowner by the Home Improvement Contractor Law. The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract, the contractor may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration _\ ffice of Consumer Affairs & Business Regulation - ME IMPROVEMENT CONTRACTOR gistration: 120296. Type: xpiration: -11/19/2015 DBA 42 TESTA BUILDING & REMODELING . -JAMES TESTA j 5 APPLETON STREET', N.ANDOVER, MA 01845 Undersecretary 6-- Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supen-isor License: CS -054718 JAMES M TESTA 5 APPLETON ST.,; N ANDOVER Mk 0145 rid �." "''' Expiration Commissioner 06/08/2016 M � The Commonwealth of Hassachasetts - Department oflnclusft!gIAceId&ts Office of -Investigations 600 Washington Street Boston, .MA 02111 www.mass:gov/riza Workers, Compensation YmuranceAffidavit: But tiers/Cony°actors/Electricxans/Plik bens A-pplicant bformati:on Please Print Led . alrie(Businosiorganizationfindividuai): I C 5 T• ,A � 1 � .`� 1` ✓+mac) e�� � � _ Address: A ppl e � �N r'ee - City/Sime/Zip: A 0 % g `► Phone "7 1� Are you an employer? Check the appropriate box: Type of project (required): 1. ❑ T am a employer with 4. ❑ I am a general contractor and I 6. [] New construction employees (iuliand/or paittime)* have hire d the sub- contractors 2. V-1ama sole proprietor or partner listed on the attached sheet 7•emodeiing ship and'haveno.employees These sub -contractors have 8. [] Demolition woxldng forme in any capacity. workers' comp. insurance. g, Building addition [No workers' comp. insurance 5. El are a corporation and its 10.❑ Electrical repairs or additions xecluired.] officers have exercised.their 3. [J I am a homeowner doing all work right of exemption per MGL 11. [( Plumbing repairs or additions myself. [No workers' comp. c.152, §I(4), and wehaven.o 12.QRoofxepairs insuxancere ed. employees. [No workers' r a 13. [1 Other comp. insurance required.] xAny applicant that checks box#1 must also fill out the section below showing their woricers' compensation policy naormanon. ►'Homeowners who submit this affidavit indicatingthey tie doing allwork and then hire outside contractors must submit anew affidavit indicating such. rConiractors that checkihis box must attached m additional sheet showingthe name of the sub -contractors and their workers' comp. policy information. I am an erne%yet' that ispYovicling luo>?kers' compensation insurance foYxny employees Below is the policy anqo ite information. Insurance Company Policy ## or Ser -ins. Lic. ExpkationDate; lob Site Address: City/State/Zip: Attach a copy of the workers' compensatlon-policy declaration page (showing the policy number and expirations. date). Failure to secure coverage as requiredunder Section 25A ofMGL o.152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civill penalties in the form. of STOP WORD ORDER. and a fine ofup to $250.00 a day agakst the violator. Be advised that a copy of this statement may be forwarded to the Office o£ Investigations of the DTA. for insurance coverage veri-fication. X do hereby cel to under the pains and penalties of perjury that the in, formation provided above fs true and correct. Phone #• I Of use orrly..Do not write in this area, to be completed by city or town official City or Town: PermitlLicense # �/`ate/ry Issuing Authority (circle one): 1. Board of Health 2. BuildingAepartment 3. Gty/Town Clerk 4. Electrical )inspector 5. Plumbing Inspector 6. Other Contact Person:_ Phone #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an ea'aployee is dewed as "...everypexson iii the service of another under any contract ofhire,- express orimplied, oral orwritien." An employeiis defined as "an individual, partnership, association, corporation or other legal entity, or any two ormore of the c orer oin engaged iu a joint enterprise, and including the legal representatives ofa-deceased employer, or the g,�J �� 9 g g p receiver or trustee of as individual, partnership, association or other legal entity, employing employees. However the, owner of a dwelling house having notmore than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to bean employer." MGL chapter 152, §25C(6) also states that "every state or local Ile -easing agency shall withhold the is or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced -acceptable evidence of compliance with the insurance coverage required." Addition0y, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance requirements of this chapter have beenpresented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, ifnecessary, supply sub -contractors) name(s), address(es) andphonenumber(s) alongwiththeir certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are notrequired to carry workers' compensation insurance. If an LLC or LLP does have employees, apolicyis required. Be advised thattbis affidavit may be submitted to the Department of htdustrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the applicatim for the permit or license is being requested, not the Department of 7n.dustrial Accidents. Should you have any questions regarding the law or if you are required to obtain, a workers' compensation policy, please call the Department at the number listed below. Self insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete andprinted legibly. The Department has provided a space at the bottom Of the affidavit foryou to .rill out in the event the Office of Investigations has to contactyou regarding the applicant. Please be -sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant thatnnmst submitmultiple permit/license applications in any given year, need only submit one affidavitiudicating current policy information (ifnecessmy) and under "Job Site Address" the applicant should write "all locations in (city or tow:[)." copy of the affidavit that has been Officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit -ii on file for future permits or licenses. Anew affidavit must be filled out each year. where a home, owner or citizen is obtaining a license ox permit not related to any business or commercial venture (i.e. a dog license orpermit to burn leaves etc.) said person is NOT xequired to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: Tho CQmmonwealt1l ofyssaoliv.:setiS - Do,pax meAt offadmWal Aadde�i oxce 0:aA-Vosagaa0)U"% 6G Was k8ton stce,Qt Boston, 9A. 02111 TQ1. # 617-72.7-4900 ex 406 o ' 1-•877-MAMAF'E Revised 5-26-05 FRY, 0 617-727-7749 www.x:0,aagovfdia NOTICE, OR SEND A TELEGRAM TO [Name of Seller], AT [Address of Seller's Place of Business] NOT LATER THAN MIDNIGHT OF (date). I HEREBY CANCEL THIS TRANSACTION. Date: __ Buyer's Signature: